| NPI | 1487306635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 171WH0202X Contractor Home Modifications |
| 172A00000X Driver | |
| 376K00000X Nurse's Aide | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-01-19 |
| Last Update Date | 2022-04-26 |